A RESOURCE FOR CAREGIVERS

Monthly Archives: July 2014

It’s never easy to speak about mental health issues so remember, it doesn’t always have to be a long conversation. There are other ways of showing support. One can send an email message. One can send a message on face book but not on the public page, of course. One can simply call and ask; ‘How are you doing?’ Small gestures like this can make a big difference.

If you think that someone is behaving differently from their usual manner of behavior, that person could be unwell so how about making it clear that you have noticed that he doesn’t seem his usual self at that time and wonder whether there is anything you can do to help. Make it clear that if your friend ever wants to talk you will be there for him or her. Or, offer practical help. Try not to avoid the subject. People with a mental health problem often mention the fact that friends and colleagues avoid them simply because they have no idea of what to say. You can ask how things have been and how they are doing, you know. They might even welcome the attention. If that person is returning to work or to your social group after a period of illness, let him know how glad you are to see him return and maybe even suggest a further chat at a later stage as it is so important to the person concerned.

People want someone to listen to and not necessarily to give advice. If you jump to conclusions and give advice, it is equivalent to not listening to that person. If you are sure that the person needs urgent help, turn to a professional for advice.

It is important to empathize but saying that you felt equally sad when your dog died, will most definitely sound like the most trivial comparison in the world. You can of course say that you have no idea what it must be like for that person as your experience cannot possibly be the same as theirs.

On no account tell that person to pull himself/herself together or that it will seem better in the morning. A person in trouble is good at picking up body language so try not to keep glancing at your wristwatch or smartphone too often to check the time.

Today, most people with a mental illness are out in the community and the scandals reported in the press are no longer about the bad treatment they receive in psychiatric hospitals but about attacks by them. As a result, journalists regard them as being quite different from the rest of us. This is an issue all over the world.

I remember reading what Ralph Emerson said; ‘Sanity is rare. Every man and almost every woman has a dash of madness.’

Aristotle wrote: ‘Nobody is exempt from a mixture of madness.’

Nietzsche wrote; ‘Insanity in individuals is rare, but in groups and in nations and epochs, it is the rule.’

So the idea that bizarre beliefs are not common in normal people is incorrect. If you follow the horoscope in the Sun Newspaper, you might have read under Aquarius somestatistics on insanity saying that one out of every four Americans suffers from a mental illness. Well, I am Aquarius, so I decided to do a simple test. I thought about three of my best friends …. and as they were not sufferingfrom a mental illness, I realized that the the fourth one could be me.

II asked a psychiatrist to explain a hallucination to me. I was told that it was something one hears in the absence of a stimulus. ‘So,’ I asked, ‘does the Pope hear the voice of God or, is a person who hears the voice of God only hallucinating?’ No reply.

Then I asked whether a delusion were a false, fixed, unshakeable idea in which people invest a great deal of emotion; like ‘My mother is poisoning me,’ or ‘they planted ideas in my coffee.’ When someone has a bizarre delusion or an unusual hallucination, it is easy to make a diagnosis but when it is not so clear, it becomes problematic.

Traditionally, psychiatrists thought that schizophrenia was a brain disease and did brain scans showing that people with schizophrenia have slightly less grey matter and that their hippocampus is 5% smaller. It is not something gross like in Alzheimer’s disease but people tend to think that these changes are partly developmental and that the disorder runs in families to some extent like heart disease or diabetes. One does not inherit it directly but one can inherit a predisposition toward schizophrenia.

When the world worried that Iraq was stockpiling mass weapons of destruction, it seemed a fixed, unshakeable belief which was held with great conviction; yet it turned out to be a false belief. But, despite this, it was NOT a delusion. Why? Because it was shared by a great number of people. What would happen if someone told me today that there are weapons of mass destruction in Iraq; would it be a delusion? It might well be because I would have great difficulty finding anyone else who believed me. So, to some extent, a delusion is diagnosed when one cannot persuade other people to believe one’s belief.

I remember another example; Mohamed Al Fayed had the belief that was widely reported in the press that princess Diana and his son Dodi were murdered as a result of a conspiracy masterminded by the Duke of Edinburgh. Is this belief within normality – or not? There does not seem evidence for it yet he has maintained it with unshakeable determination for a long time although, as far as we can tell, it is false. It is however, understandable.. His son was on the verge, so he thought that an important relationship with royalty imight have been the cause.

So I would like to conclude that the general population is ‘sane’ and that there are only a few people with schizophrenia who are in hospital or, who should be there; then psychiatrists began to think that maybe some people who are a bit paranoid should be part of the spectrum; and now we think that a considerable proportion of the population probably have minor psychotic ideas the way we place people being somewhere on the distribution of diabetes or obesity.

Therefore, maybe we should not think that people with schizophrenia are something like an alien race and very different from the rest of us. In face, if we are given the right environmental circumstances, most of us have the capacity to develop psychotic ideas and have hallucinations as well as delusions.

‘Mental Illness fills my brain. It takes over completely .There is no escape. The voices! Oh the voices! If you could live in my mind for just one day, you would not think I was okay. You might understand what it is like, to have no peace of mind. I get tired from simply trying to do regular things, tired from simply trying to live my life. The medication I am given does not seem to help. I don’t know what to do.’

‘Chronic pain fills me inside and takes over my body. There is no escape. It is crushing. If you could live in my body for just one day, you’d never think I was okay. You might understand what it’s like to be tired from simply trying to live and do what’s required. I wish I could explain the depth of my pain It’s never-ending, so hard to explain. I’m aching inside, not easy to hide. I wish I could tell you how I honestly feel. But would you believe that my pain was so real?’

So remember: Your life may not be tied in ribbons, but, it is still a gift.

People aim to comfort a parent who has lost a child. So few really know what to say.

Our son, Doron, was a healthy, strapping young man who loved sport, particularly surfing. When he was drafted into the military and into a fighting unit, the last thing we contemplated was illness. He was far too healthy. Sometime during his military service, something happened to his mind and much later, long after he completed his three years compulsory military service, he was diagnosed with paranoid schizophrenia.

Then, before his 34th birthday, he released himself from a mind that tormented him and as his mother, I was released from watching him suffer. We were parted forever . I mourn him, I miss him, I’m angry and sad, particularly because he ended his life to quiet the voices in his head that no modern medication managed to alleviate. It took a long time for me to forgive him for taking my son away from me. I wondered when and whether I would ever be happy again.

Few people knew what to say to us grieving parents, particularly because suicide was concerned. What does one say to grieving parents? What does it mean to offer condolences? Well, all I can tell you is what we didn’t want to hear.

I would die if I were you: This is only a manner of speaking and not remotely true. Human beings are built to withstand all kinds of calamities and they survive although probably changed forever. However, they continue to live. When we heard the above, we felt as if this person were predicting that we would never be happy again and that if we do manage a semblance of happiness, we should really feel guilty. Believe me, I felt cursed and didn’t need anyone to make it worse.

So what could that person have said? This must be the hardest thing in the world for you. Remember that I am thinking of you.

I can’t imagine howyou must be feeling: This didn’t work either because if the idea of losing a child couldn’t be so terrible unless you could imagine it. Grief is isolating. I felt as if there was an unwritten line drawn between the rest of the world and myself. I felt so very alone and vulnerable. I needed empathy, not pity. So, what would I have preferred to hear? I feel so sad for you and your family. What can I do to help you?

I have no idea what you are feeling: But you do. You feel sadness because the death of a child by suicide after a long illness is one the saddest and incomprehensible things in the whole world. I feel so sad would have sounded so much better.

While growing up, we were taught rather shallow, standard things to say when people die but most of what we learned lacked emotional engagement which is the very thing that grieving people need – in fact, it’s what they long for particularly in those early days when the grief is raw.

We should think deeply about what they would most like to hear. I have seen grieving parents actually cringe. I believe that the best way to comfort somebody is to listen to them because in this situation, it is not about you, but about them. That person has a great need to talk so let them. Allow them to say what they feel. The flags below show the stages that grieving parents will go through.